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Active and Successful Aging. Lifestyle as a Gerontological Idea

Stephen Katz
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Sociologists Georg Simmel and Max Weber conceived the idea of lifestyle to identify the social connections between individualism and consumerism that emerged with modernity. Pierre Bourdieu, Anthony Giddens and others have given lifestyle critical relevance in their work by including questions of agency and structure in post-traditional society. However, the idea of lifestyle has also become central to gerontological studies and the caring professions around aging and their models of “active” and “successful” aging. At the same time, such models have neglected the theoretical and critical value of lifestyle as a concept for understanding age inequalities and the social determinants of health in later life. This article revisits the story of lifestyle in order to reinstate its importance to aging studies. The conclusion considers the example of falling for older people to illustrate how such a crucial issue is also an opportunity to think about lifestyle in critical and reflexive terms.

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I. Introduction

1 The theme of the 64th Annual Scientific Meeting of the Gerontological Society of America (GSA) in 2011 was “Lifestyle Leads to Life Span”, a well-phrased banner asserting that “how” one lives affects “how long” one lives. The pairing of active individual agency implied by “lifestyle” with the indeterminacy of biology implied by “life span” is part of the general goal of “successful aging”, a familiar ideal within gerontology (discussed further below). At this conference I presented a paper for a symposium on “lifestyle in social context”. I was struck by the juxtaposition of our symposium, where participants discussed critical aspects of lifestyle such as class, age and gender inequalities, within a conference whose theme and agenda largely neglected such aspects. The conference experience certainly demonstrated the breadth of lifestyle as a resourceful gerontological idea that pulls together popular, political and practical strands of aging research. Lifestyle is also an axiomatic term in global health and risk-management promotion, World Health Organization reports and internationalized diet and exercise industries. However, the overriding assumption in these professional knowledge-making areas is that lifestyles are volitional and discretionary; an assumption buoyed by empirical data favoring individualistic principles of choice and identity over processes of social constraint and historical contingency. Hence, lifestyle has a dual life in aging research. On the one hand, lifestyle in the mainstream gerontological fields is used to promote healthy and successful aging, and on the other hand, lifestyle is used as a critical concept to signal gerontology’s neglect of diverse aging experiences and social and environmental determinants of health. Hence lifestyle is one of gerontology’s most circulated keywords, but also one of its most debated. For purposes of this article, I treat lifestyle as an interesting theoretical opportunity to explore those spaces of thought in gerontology where sociological and health studies intersect, in particular along vectors of identity, agency, structure and biopolitics.

2 My inquiry here follows my contention that understanding problems of aging involves probing and tracing the concepts and discourses with which such problems are addressed and become sources of truth. In previous writing (Katz, 2003), I engaged in this exercise of disciplinary reflexivity by borrowing from Pierre Bourdieu his critical analytics of “fields” and theoretical methodology of “fieldwork in philosophy” (Bourdieu, 1990), and from Michel Foucault his critical orientation toward genealogical histories (1977). For example, in my chronicling of gerontological handbooks I examined the textual vocabularies, literary designs and rhetorics by which gerontology represents itself as an authority on aging (Katz, 2000a). In a related study I traced the currency of the master-concept “activity” in gerontology as a theoretical model, a cultural ideal, an empirical instrument, a healthcare regime, a political rationality and a discursive resource (Katz, 2000b). In a similar vein, my colleague Barbara L. Marshall and I have examined the meaning and ubiquity of “function” and “functionnality” in relation to aging (Katz, 2006; Katz/Marshall, 2004). Currently I am working on the applications of new ideas about memory loss, cognitive impairment and neurocultural developments in the aging field (Katz, 2012; Katz/Peters, 2008). In all this work I find that it is not just the meaning of gerontological ideas that inspires a critical curiosity about them, but the life of these ideas and their social contingencies, practical consequences and wandering beyond their disciplinary boundaries. When Simon Biggs examines aging policy from a narrative perspective (2001) or Victor Marshall looks at the idea of “case study” in an interpretive critical light (1999), they shift the ground of understanding policies and case studies by shaking up their conceptual architecture. If, as we are told, aging is a new world promising vast changes at every social register, then new approaches to the ways we think about aging are also necessary, including interrogating the idea of lifestyle.

II. The Sociology of Lifestyle: Simmel, Weber, Bourdieu, Giddens

3 At the outset it is important to trace the sociological origins of the idea of lifestyle in order to see their critical roots. The very term “lifestyle” is attributed to social thinkers Georg Simmel and Max Weber (and sometimes Thorstein Veblen). Simmel, in investigating the urban metropolis and the money economy as new sites of modernity at the turn of the twentieth century emphasized their consequences for the increasing social differentiation, objectification and alienation of human relations. He critiqued what he called a new “style of life”, that

presents itself to us as an objective totality but is in fact composed of a fragmentary, fleeting universe of the world of circulation and exchange (Simmel in Frisby, 1992:74).

4 Furthermore, for Simmel there is “a tendency towards extreme subjectivism” (Ibid.:76) because of the social pressure exerted by these sites on people to individualize their social lives as unique and to celebrate the expression of such lives in distinctive ways. Most importantly for Simmel, modernity creates new forms of inequality and marginality that become manifested as novel types of characters, such as the stranger, the modern prostitute, the adventurer and the poor person. These types are especially salient in the urban metropolis where dissociation is a common element of the metropolitan style of life as it threatens to overwhelm the individual. While Simmel was one of the first sociologists to study leisure, fashion and travel – what we would eventually classify as lifestyle components – lifestyle was hardly a choice, but rather a means to fix identity in the fragmenting and fleeting experiences of modern life through a coerced and exaggerated form of individualism (Levine, 1971). Lifestyle activities were also strategies for new forms of stratification based on social psychology ; for example, in Simmel’s essay on The Alpine Journey he describes alpine travel “as an important element of the psychic life of our upper strata” (1992 :96).

5 In the early twentieth century Max Weber, along with Simmel, used the idea of “style of life” to expand his critique of status beyond, but not detached from, class division. In Classes, Status Groups and Parties, Weber says that while people may have pretensions to certain social statuses through their lifestyles, “the possibility of maintaining the life-style of a status group is usually conditioned on economics” (Runciman, 1978 :52). Life-style is a social form of class formation that is expressed symbolicaly, behaviourally and/or morally. For Weber, class and status are two interpenetrating orders of privilege and difference, where

choice is the major factor in the operationalization of a lifestyle ; however, the actualization of choices is influenced by life chances (Cockerham et al., 1997 :325).

And “life chances” are always consequences of social structures. This means that lifestyles are defined by a dialect between choice and constraint across the lifecourse through the accumulation of social advantages and disadvantages. Thus Weber’s thinking about lifestyle is particularly relevant to aging and health where life chances, status differences, healthy outcomes and lifestyle choices become articulated in ways that represent each other. Cockerham (2005) adds that Weber’s work inspires us to understand healthy lifestyles as constituting

a form of consumption in that the health that is produced is used for something, such as longer life, work, or enhanced enjoyment of one’s physical being (2005 :55).

6 Even the self-management of risks requires health literacy skills associated with a kind of personal reflexivity acquired through class socialization. For Weber, therefore, lifestyle was also a matter of collective routines and coordinated behaviours, however random the prevalence of individual choice appeared to be. Thus Weber claimed that the macro-level of lifestyles should be the object of sociological analysis. For example, individuals may choose to quit smoking for health reasons, but that choice itself is configured by particular state laws banning smoking, the social stigmatization of smokers, the association of smoking with irresponsible lifestyles or lower class groups, policy discourses about rising healthcare costs related to smoking, research on smoking and pregnancy, etc. Indeed the “smoker” has become a deviant status of its own, representing a kind of person who embodies our cultural stereotype of addictive and risky behaviour apart from the physically unhealthy effects of smoking.

7 Simmel and Weber’s classical conceptualizations of lifestyle established it as an important but fluid social zone between choice and constraint, class structure and social differentiation, and status and order. As such, the idea of lifestyle became a core field within contemporary critical sociology, especially in the work of theorists Pierre Bourdieu and Anthony Giddens. Bourdieu’s elaboration of lifestyle is most fully outlined in Distinction : A Social Critique of the Judgement of Taste (1984), where he links it to habitus, cultural capital and social structure. In Bourdieu’s words, “conditions of existence” combine with “positions in the social structure” which then produce “habitus”. Habitus then creates a “system of schemes” and practices, perceptions and tastes, that then results in lifestyle, “a system of classified and classifying practices” (1984 :171). Indeed, the freedom to choose one’s lifestyle is itself part of an advantageous lifestyle, but one that disguises its structural underpinnings and consumerist ethics. Of direct relevance to aging studies are Bourdieu’s remarks that health lifestyles are predominantly middle-class not only because of privileged access to health and exercise products, but also because such lifestyles are “only meaningful in relation to a quite theoretical, abstract knowledge of the effects of an exercise” and “presuppose a rational faith in the deferred, often intangible profits they offer (such as protection against ageing or the accidents linked to age)” (Ibid. :214). Since habitus is a kind of internalization of social constraints transposed into personal dispositions towards healthy choices, it is no surprise that upper and wealthier strata with the most access to health benefits and services are also the most capable of linking their own health behaviours to positive lifestyle outcomes.

8 It is difficult to identify a concise definition of “lifestyle” in Bourdieu’s work since he applies the term in several different formats that span specific theoretical foci to more popular cultural usages. However, what is consistently relevant in Bourdieu’s assertions is that lifestyle reflects, generates and articulates differentiated spaces of consumption, social “habitus” positions and individualized practices. These processes result in the creation of specific lifestyles (e.g., the “lifestyle” of the artist) as well as the circulation of general lifestyles by which one can pursue social mobility. Applying Bourdieu’s ideas to aging, Gilleard and Higgs (2005) describe how the ascent of a postwar “youth culture” created a new set of lifestyle aspirations that differentiated the postwar cohort from those before (and after). Such aspirations were not based on class so much as on the consumption of goods that framed the new cohort as liberational, rebellious and obsessed with the pursuit of the fashionably “new” :

The desire to embrace what was new and reject what was old was felt at least as strongly by working-class youth as it was by the middle class. It focused upon sources of “horizontal” differentiation, eliding “youth” with “freedom” and “leisure” (Gilleard/Higgs, 2005 :152-153).

9 Most significantly, as this group matured into the decades of the later twentieth century, they carried with it their particular lifestyle expectations so that today’s “boomers” and “third agers” continue to express their aspirations through consumerism. Hence lifestyle, in this sense, defined a generational field constituted by choices that distinguished the postwar cohort as special, “new”, empowered and unrestricted by class, age or physical change ; precisely the features of the commercialized retirement culture that would come to prevail today.

10 In relation to Bourdieu, the work of British sociologist Anthony Giddens is also relevant to the critical usage of lifestyle because of how Giddens puts lifestyle at the forefront of his theories of choice, identity, risk and reflexive individualism in post-traditional society. Best known for his work on “structuration theory”, Giddens has written extensive critiques of those lopsided accounts that privilege either human agency or social structure in determining lifestyles (1991, 1999). Rather, according to Giddens, the cultural contexts of late modernity and self-identity have become increasingly indeterminate, future-oriented, internally referential and reflexive. Hence, human agents respond to these contexts by engaging in a “reflexive project of the self”, a continuous ordering of self-narratives and lifestyle practices within the widening subjective possibilities of post-traditional society. While lifestyle practices appear to emanate from individual choice, supported by various forms of expertise, Giddens, harkening back to Weber, is clear that choice depends on the structural orders that configure life chances and socially embed lifestyle identities. However, in post-traditional societies :

Self-identity for us forms a “trajectory” across the different institutional settings of modernity over the durée of what used to be called the “life cycle”, a term which applies much more accurately to non-modern contexts than to modern ones. Each of us not only “has”, but “lives” a biography reflexively organised in terms of flows of social and psychological information about possible ways of life (Giddens, 1991 :14).

11 Thus, “the lifespan becomes more and more freed from externalities associated with pre-established ties to other individuals and groups” (Ibid. :147). Again, while choice animates lifestyle, it is also historically and generationally articulated within modern systems of status that intersect with, but are not necessarily determined by class. Part of the power of this choice emanates from what Giddens calls the “colonisation of the future” (Ibid. :111), whereby we have become accustomed to the idea that we can determine the fate of our futures, however unknown they may be, through specific practices based on the calculation of risks and insurential logics. Bringing the future into the present in knowable and calculable ways is an important aspect of how models of healthy or successful aging are perceived as achievable through lifestyle spaces of consumption.

III. Structure-Agency and Post-Traditional Lifestyles

12 The lifestyle ideas which Giddens, Bourdieu and their associates advance have also been criticized by feminist thinkers for overlooking the irony that post-traditional culture reinstates traditional gender relations (Adkins, 1999, 2001 ; McNay, 1999) as well as other forms of status based on race, ethnicity, (disability) and region. They also say little about age, except Giddens hints at how post-traditional society loosens individuals from pre-established life-course identities and opens up a realm of contingent possibilities about new ways of life (1991 :147). But the connection between age and lifestyle has been taken up in other areas ; in particular, by two critical literatures within aging studies. The first is the work of cultural gerontologists who examine how chronological and generational boundaries, which had traditionally structured the stages of life, are becoming blurred and indeterminate due to late-capitalist consumer society, new work and retirement cultures, leisure and consumer cultures, advances in longevity technologies, campaigns for positive aging imagery, and increasingly healthier and larger aging populations in Western societies. As middle age becomes extended farther into later life, mid-life technologies and lifestyles of bodycare become more prominent across the life course (Featherstone/Hepworth, 1995 ; Gilleard/Higgs, 2000, 2005 ; Gullette, 2004 ; Katz, 2005). Thus Gilleard and Higgs remark that,

only in the late twentieth century has the idea emerged that human agency can be exercised over how ageing will be expressed and experienced (2000 :3).

13 These critics also caution that while claims of post-traditional choice, experimentation and liberation have opened new avenues of self-definition for older individuals, such ideals can diminish the genuinely ethical struggles to live successfully, diversely and meaningfully in our society. Yet the idea of a flexible, choice-driven life course has moved from a cultural realm to a political economic one. As Grenier remarks,

The focus on lifestyle choice that is now available in socio-cultural discourses and public policy reflects a contemporary understanding of the lifecourse as blurred rather than age- and stage-based (2012 :95).

14 The second area linking age, lifestyle and social theory has been developed by social gerontologists also concerned with the relationship between agency and structure, such as the work of Jon Hendricks and Victor Marshall (Hendricks, 2003 ; Hendricks/Hatch, 2009 ; McMullin/Marshall, 1999 ; Marshall/Clarke, 2010). In this literature the idea of lifestyle is treated as an obvious connexion point between agency and structure as it is located across a continuum of social gerontological perspectives. At one end of this continuum, role theory or functionalism or certain variants of political economy propose that structural features determine the conditions of aging identity-ascription, over which individuals have little control. At the other end, theories based on the interpretive traditions emphasize that individual agents engage in a continual process of negotiating and recreating their identities by drawing upon the social resources of everyday worlds. Marshall and Clarke (2010) provide an elegant dissection of the agency-structure debate within social gerontology. Taking off from Giddens’ work, they trace the multiple usages of agency in the literature and conclude that a dynamic model of agency and structure is crucial to gerontological theorizing. Likewise, Hendricks and Hatch evoke the work of Weber, Bourdieu and Giddens to elaborate lifestyle as an articulating force between agency and structure, arguing that

lifestyles and social resources deriving from social arrangements work in tandem to structure the life course, yielding cumulative advantages or disadvantages leading to one or another experience in older age (2009 :440).

15 These and related critiques make it clear that aging research has to theorize lifestyle beyond factorial and certainly behavioural explanations. As Hendricks and Hatch contend :

In accounting for the diversity that appears to accompany the aging process, investigators have been slow to attend to the structural circumstances that anchor lifestyles and that are important sources of the variation that is now widely acknowledged to characterize older cohorts. We theorize that lifestyles and social resources deriving from social arrangements work in tandem to structure the life course, yielding cumulative advantages or disadvantages leading to one or another experience in older age (2009 :440).

16 Further, in the critical gerontological literature, lifestyles are implicated in life worlds that accumulate advantages and disadvantages over time, an idea that has been productively elaborated by gerontologists such as Dale Dannefer (2003, 2006) and Toni Calasanti (Calasanti/King, 2011). Their work details the micro-levels of inequality and stratification whereby relations of power constitute age hierarchies and intersectional orders of identity. Lifestyles are not simply traceable on a continuum between agency and structure but embed asymmetrical social relations into this continuum over time. These include new agential freedoms that might be emerging around lifelong learning or retirement-planning or health “smart” diets, for example, where they become part of a governmental rationality that maximizes individual responsibility in the service of meeting political goals of minimizing dependency and universal entitlements especially in North America and Britain. In countries with different political configurations and histories such as France (or Germany) where liberalism is seen “as a suspect doctrine” (Donzelot, 2008 :116), state intervention is levelled “on society itself so that it can be regulated by the market” rather than intervening on the market in particular (Ibid. :129). Hence the support of state health, family and labour benefits and expectations for individual self-care and responsibility vary as they become embroiled in separate national debates between political parties and governmental positions. However, I also believe, as the next section argues, that a neo-liberal and entrepreneurrial style of thought about aging has entered the health and retirement fields through an internationalization of gerontological ideals aimed at active and successful lifestyles (Hamblin, 2010 ; Moulaert, 2012).

IV. Lifestyle in Healthy Aging Discourse and Practice

17 Given the wealth of ideas on lifestyle, structure and agency produced by the two critical areas on aging discussed above, and their links to the broader story about lifestyle stretching from Simmel and Weber to Bourdieu and Giddens, why does so little of these traditions penetrate the other story about lifestyle in aging research with which this article began, that is, “lifestyle leads to life span” ? One reason is that lifestyle has become incorporated within the successful aging paradigm in American and increasingly internationalized gerontology, which blunts the concept’s social and critical dimensions. For example, in an 1997 edition of Science magazine, John Rowe, one of the creators of the paradigm, declared that a “new gerontology” was emerging characterized by the recognition that successful aging also requires “full engagement in life, including productive activities and interpersonal relations” in addition to health maintenance (Rowe, 1997 :367). And further, Rowe contended that “health and functional status in late life are increasingly seen as under our own control” (Ibid. :367). This is less a “new gerontology” than a reiteration of what can be found in most health promotion campaigns, risk-management medicine and popular marketing industries about measurable and modifiable lifestyle factors. These factors in turn accumulate into pathways towards successful aging, an idea going back to the 1950s in gerontology, but crystallized in the work of John Rowe and Robert Kahn (1998). Here successful aging is defined not simply by the low probability of disease and high physical and cognitive function, but also by the active psychological ability to engage with life in ways that appear unrelated to social position or status. Further, knowledge construction about successful aging is based primarily on empirical testing so that “the successful aging paradigm seems to define “success” as an outcome, rather than a process” (Dillaway/Byrnes, 2009 :706).

18 On the surface the popularity of the successful aging paradigm is due to its person-centered explanations, but in a deeper sense such popularity arises because the paradigm “defeats the political lobbying for more social support and resources” (Ibid. :708).

Thus, the very ideologies and political values that encourage the creation of successful aging discourse also may thrive on that discourse once it is created (Ibid. :713).

19 This discourse animates lifestyle as a narrow and individualistic set of practices overdetermined by their relationship to empirically driven predictors of successful aging. For instance, in a recent article on Lifestyle and Successful Aging : An Overview in a new journal called the American Journal of Lifestyle Medicine, the summary of social theories of aging are limited mainly to the dated individualistic and functionalist disengagement and activity debates, despite the article’s ambitious title (Franklin/Tate, 2009). Lifestyle is also typified into choices around smoking, diet, exercise and the authors assert the familiar theme that “the predictors of successful aging are in many ways under personal control” (Ibid. :8). Similarly, a Survey in Europe on Nutrition and the Elderly : A Concerted Action (2003), following a ten-year European longitudinal study between 1988-1999, attempts to identify dietary and lifestyle factors that contribute to healthy aging. The researchers conclude that, “public health programmes should focus on the adoption of health lifestyle behaviours in elderly people” and that

the identification of people with unhealthy lifestyle habits, and finding ways to improve lifestyle habits of specific target groups is the challenge of future prevention programmes in young and elderly subjects (Haveman-Nies et al., 2003 :432).

20 The successful aging paradigm also pays scant attention to those whose lifestyles are less driven by choice than challenged by managing dependency and living with disabilities (Minkler/Fadem, 2002). This problem adds to the general neglect within the paradigm and mainstream gerontology of the ways in which critical lifestyle analysis can illuminate the social circumstances, contexts, structures, cumulative disadvantages, status divisions and life chances that marginalize and devalue the lives of older people. Outside of the traditions discussed above that attempt to widen the interdisciplinary traffic between theoretical sociology, health and aging studies, mainstream gerontology continues to isolate lifestyle within an individualistic, successful aging paradigm. This is not just a theoretical issue in the construction of later life because there are practical and policy consequences. Again, discourses and models of aging frame treatment, care and the making of older subjectivities. In this sense, the final section of this paper takes the issues of falling and fall prevention for older individuals as illustrative of how serious practical matters are also a testing ground for the critical application of lifestyle.

V. Falls, Fall Prevention and Lifestyle

21 This section is based on my interpretive summary of studies about aging and falling in selected Western societies, with a focus on the relationship between the individual “faller” and the social conditions in which they and the treatment of falling exist as mediated by lifestyle. I think it is also a good example of how a brief and terrible moment in time, a fall, encompasses the larger fields of health, environment, the professions and social status and brings them to bear on the individual in ways that make it impossible to see successful aging as driven simply by lifestyle choice. Rather, a wider critical lens on lifestyle is required.

22 The gerontological literature portrays a frightening statistical picture of the numbers, frequency, injuries, hospitalizations, deaths and costs of falls amongst aging populations. In America between 45 % and 61 % of nursing home residents fall each year resulting in significant cases of hip fractures, with the mortality rates in the year following the fracture estimated at between 14 % to 35 % (Carroll et al., 2008 :213). Even for those who survive a hip fracture, many fail to recover normal bodily functioning. In Canada falls are a major cause of injury, a reason for entering care facilities, a factor in morbidity, and an expense to the healthcare system. The World Health Organization’s WHO Global Report on Falls Prevention in Older Age (2007) estimates that 28 % to 35 % of people 65 years and older fall each year, with the fall rate increasing with age (WHO, 2007 :1-2). While there are differences in national surveys of fall-related incidents (Peel, 2011), most experts generally agree that falls are increasingly costly and that fall prevention programs are increasingly necessary. Of course fall prevention itself is also costly and as one study’s title asks, How Much Are We Willing to Pay to Prevent a Fall ? (Jenkyn et al., 2012).

23 The risks of falling are obviously a formidable daily presence and are a fault line between individual and structural determinants of health, safety, independence and support. On one side of this line, older individuals, who are rarely consulted, often attribute falls to losing balance, slipping, tripping, falling, etc. because this is what it feels like to fall in an embodied subjective sense. Falls happen inside a relationship to an external environment. However, on the other side, health care professionals generally consider falls in terms of injuries and poor health (Zecevic et al., 2006), thus favouring individual measurements of risk factors over larger environmental and structural relations (Laybourne et al., 2008 ; Oliver, 2008). Knowing that one third of all people 65 years and older have fallen at least once each year is a collective risk based on age, a “fact” to be mediated by an individual’s management of their bodies, homes and medications. Yet this double register of risk – collective and individual – in fall prevention programs emphasizes individual autonomy typically advocating behavioral change (exercise regimes, healthy living, medication regulation) along with the individual making residential modifications (better lighting, non-slip surfaces, safe outdoor areas). As the WHO Report (2007) makes clear, “active aging” is the key strategy for fall prevention, even though such a strategy depends for its success on adequate resources, supportive environments and long-term governmental commitment. The active aging themes of exercise and psychological control espoused in fall-prevention programs are also echoed in the many popular advice books currently on the market, with titles such as Fall Prevention : Stay on Your Own Two Feet (2006), Fall Prevention : Don’t Let Your House Kick You Out (2006) and How to Prevent Falls : Better Balance, Independence and Energy in 6 Simple Steps (2007).

24 However, in reality fall-prevention agency and lifestyle changes are socially mediated. For example, gender is a crucial variable in fall prevention because the common image of women’s bodies is that they are weaker, more vulnerable and more risk-prone (especially after menopause due to osteoporosis) compared to those of men. If women do fall more often and suffer more fracture-related falls than do men, this is also a social consequence of the embodiment of asymmetrical gender relations and the cultural bias that depicts female physical strength as unfeminine and older female frailty as natural (Grenier, 2006 ; Grenier/Hanley, 2007). Women are often given a higher number of medications and some falls may be attributable to women’s use of psychotropic drugs and not their lack of physical endurance (Fletcher, 2002). Even micro-technologies such as grab-bars, non-slip surfaces, and easy-to-reach faucets, which are all helpful, evoke larger structural lifestyle issues around social support, independent living and affordable “age-friendly” housing. In Canada, despite the fact that 10-15 % of all non-syncopal (not due to sudden loss of consciousness) at-home falls happen in bathrooms, fewer bathtub grab-bars are installed in privately owned buildings than in buildings publicly owned. Since one third of all Canadian seniors live in apartment buildings, this is a political issue that affects lifestyle and is not simply a problem of individual choice (Edwards et al., 2006). In fact the grab-bar is a good example of the social contextualization of lifestyle and its embodied habitus within a microcosmic world of the bathtub, the bathroom, the apartment, and the wider community.

25 And when a fall does happen, it is assumed to happen to people who lack the physical control to “hold on”. The newly created “faller” enters a professional world of care, risk and prevention programs, or hospital and community centers, whose authoritative vocabularies define them as such. Thus the process of falling out of one world and into another is, again, not just an individual event. Rather, falls are a point of convergence for knowledge-making in gerontology as it navigates the practical and ethical corridors that separate autonomy from dependency and agency from structure in old age. Falls cannot be completely defined, operationalized, predicted or prevented. Yet their complexity tells us that treatment and intervention have to take into account social, gendered and political determinants of health in old age, areas into which gerontological priorities on individualized rehabilitative, active and risk-aversive practices must expand. The fall is just one issue that illuminates why the recent individualistic story of lifestyle, the one that leads to improving or lengthening lifespan, needs the critical edge of the other older story, the one that positions lifestyle in the myriad of life chances, status hierarchies and social contexts in which it was first theorized. The fall is also just one opportunity to apply the sociological power of lifestyle to the gerontological imagination, but there are others that could be added to it including nutrition, housing, mobility, disability, care relations, volunteerism, generational identities and aging futures. In all these areas lifestyle is the complicated series of spaces whereby individual agency and social structure come together in ways that define aging today.

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Long summary

This article examines the meaning of “lifestyle” as a gerontological idea and its discursive role in bringing together popular, political and practical strands of aging research. Sociologists Georg Simmel and Max Weber conceived the idea of “lifestyle” to identify the social connections between individualism and consumerism that emerged with modernity. Pierre Bourdieu, Anthony Giddens and others have given lifestyle further critical relevance by including questions of agency and structure in post-traditional society. Lifestyle has also been a central resource in health promotion, World Health Organization reports, successful aging models, and diet and exercise industries. The overriding assumption in successful aging models within gerontological professional practices is that lifestyles are volitional and discretionary, buoyed by data favoring individualistic principles of choice and identity over processes of social structure and historical contingency. Thus such models have neglected the theoretical and critical value of lifestyle as a concept for understanding age inequalities and social determinants of health in later life and the diversity of the aging experience itself. These problems, in turn, have been highlighted by the critical lifecourse literature that combines the work of Giddens and Bourdieu on lifestyle and structure-agency relations, with cultural sociologists who write about the effects of late capitalist consumer culture on aging identities.

Lifestyle, therefore, provides an interesting theoretical opportunity to explore those spaces of thought where gerontology, sociology and health studies intersect, in particular along vectors of identity, agency, structure and biopolitics. Such an exploration is the purpose of this article with the aim to reinstate the importance of lifestyle to aging studies in critical and reflexive terms. To do this and to illustrate the friction between lifestyle models in gerontological thought, the concluding part of this article takes the example of falling and fall prevention for older people. Falls mark several boundaries lines between an individual’s experience and the structural determinants of health and safety. For the individual, health and fall-prevention professionals favour objective and medical analyses based on injuries, mobility, and physical health, over the individual’s own interpretation of their falls and relation to external environments in terms of “slips”, “trips”, or “accidents”. Thus falling, as a meaningful embodied event that ties together the inside and outside of aging, is not fully understood. The professional and medical production of the “faller” as a type of vulnerable aging subject, also transforms their external realities into lifestyle choices. This production further reduces the significance of the structural relations of health and risk which determine the wider organization of lifestyle, as originally envisioned by Simmel and Weber based on social contexts and cumulative life-chances. By connecting falling and lifestyle, the article contributes to the growing interdisciplinary field between theoretical sociologists, health studies and aging researchers, who are advancing the critique of the marginalization and devaluation of older people today.

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Stephen Katz, « Active and Successful Aging. Lifestyle as a Gerontological Idea »Recherches sociologiques et anthropologiques, 44-1 | 2013, 33-49.

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Stephen Katz, « Active and Successful Aging. Lifestyle as a Gerontological Idea »Recherches sociologiques et anthropologiques [En ligne], 44-1 | 2013, mis en ligne le 20 septembre 2013, consulté le 29 mai 2024. URL : ; DOI :

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Stephen Katz

Department of Sociology, Trent University, Peterborough, Canada

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